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WWYD, newborn with a high fever?

post #1 of 31
Thread Starter 
Just for the record, I know what I did, as this happened 2 weeks ago. But I'm curious how others here would have reacted.

Anyway, 2 weeks ago I had an evening meeting. When I finished the meeting, DH handed me DS2, who had been sleeping on his chest. The baby was 6 weeks old. I thought he felt hot, but it had been a warm day and he was in kind of heavy pj's. So I changed his pyjamas and waited for him to cool down. No luck. I started to nurse him and the second he latched on I knew he had a fever. I let him nurse a bit, then took his temperature-- it was 103.6.

What would you have done in this situation?
post #2 of 31
Personally, with a 2 month old, I would have gone straight to the dr. or ER. That would be a fever to high, in a baby too young for me to wait it out at home.

That's just me though - I hope he's feeling better now
post #3 of 31
cool cloths, nursing, nursing, nursing...if it didn't get better, the I would have called the DR.
post #4 of 31
I would go straight to the ER.

This happened to us when dd was 6 wks old. Turned out she was septic from a UTI and very VERY ill even though she "looked" ok and was nursing well. We spent over a week in the hospital, but I hate to think of what might have happened if we had tried to wait it out. So yeah, fever in an infant under 3 months old, I would go straight to the ER.
post #5 of 31
Quote:
Originally Posted by kyndmamaof4 View Post
cool cloths, nursing, nursing, nursing...if it didn't get better, the I would have called the DR.
This along with a warm bath, skin to skin.
post #6 of 31
This happened to me when DS1 was 5 weeks old- I went right to the doctor.
post #7 of 31
Straight to the ER. If the child was older, I would of nursed.

So, what did you do?
post #8 of 31
Thread Starter 
We went to the pediatric ER nearest us immediately. They took blood, bagged DS for urine and admitted us. It turned out that he had a UTI, which luckily had not reached his kidneys. We were in the hospital for 3 days, then went back for another week for IV antibiotics.

I might have tried to wait it out, but the ped I saw two weeks after DS was born told me that babies his age weren't "allowed" (as she put it) to have fevers. Anyway, I was just wondering if the consensus here was to go to a dr or the ER, or if it was to wait it out...
post #9 of 31
ER

After a friend of mine had a scary experience re. newborn w/fever (didn't take him in right away and by the time she did it was a real life-threatening emergency), I will always err on the side of caution (and beg anyone who asks my advice to err on the side of caution as well)!
post #10 of 31
An older baby/toddler I would nurse, cool cloths, acetaminophen for comfort if necessary...

An infant I would bring in immediately. I work in the ED, and just last week got to bag a newborn flown in by helicopter. He was septic, and admitted to ICN.

The parents were blown away. Baby was 28 days old.
post #11 of 31
Thread Starter 
Ceinwen, just out of curiosity, at what point would you consider a baby old enough to wait it out? Three months? Six? I'm also planning to ask the ped at our monthly check-up on Saturday at what point fevers are no longer a serious emergency...
post #12 of 31
So, do newborns not present w/ other symptoms when they have a UTI? How do they get them?
post #13 of 31
Thread Starter 
Quote:
Originally Posted by claddaghmom View Post
So, do newborns not present w/ other symptoms when they have a UTI? How do they get them?
In our case there were no other symptoms. Baby was nursing well and sleeping well until he developed the extremely high fever. As for "how", well, bacteria got up his urethra. I was asked how I clean him-- whether I used packaged wipes, which can irritate things. I use warm water and cotton wipes, so was doing everything right. I'm extremely vigilant now about thoroughly drying him off before putting a new dipe on. They also did an ultrasound while we were in the hospital to check for a malformation that can mean greater likelihood of UTIs, but he doesn't have that.

It was one of the scariest experiences of my life so far. They were talking about doing a spinal tap, and about the possibility of an infection he got during birth, even though I tested negative for that test...
post #14 of 31
I work in ED too and I would take a baby that young straight in, especially with a temp that high!

Probably after about 6 months I would try other things *if* they had no other signs/symptoms and were feeding and weeing well but I wouldn't try for very long. Once they were over a year I would probably try for a bit longer. And my first port of call might be the GP rather than ED if it was during office hours which I wouldn't do with a tiny.
post #15 of 31
Quote:
Originally Posted by Marylizah View Post
Ceinwen, just out of curiosity, at what point would you consider a baby old enough to wait it out? Three months? Six? I'm also planning to ask the ped at our monthly check-up on Saturday at what point fevers are no longer a serious emergency...
Between 6 months and 12 months, I would worry slightly less, but would still seek out care fairly quickly (taking other things into consideration - hydration, behaviour, etc.) After 12 months, I'd worry slightly less.

And it's funny, because I'm an extremely delayed/selective vaxer, lean towards naturopathic medicine, etc. - but most people assume since I work in the ED I'm hardcore into allopathic medicine.

That's why I chose emerg though, I like working on traumas/real emergencies, regular medicine bores me!
post #16 of 31
Quote:
Originally Posted by claddaghmom View Post
So, do newborns not present w/ other symptoms when they have a UTI? How do they get them?
Often the only symptom is high fever, sometimes poor eating, lethargy (which is sometimes hard to detect in infants). Some children are just predisposed to UTI, but often in cases of infant UTI, the child has a condition called vesicoureteral reflux (kidney reflux) where the urine moves from the bladder into the kidneys where it can cause serious complications and permanent damage. As for how they get them, no one can really say. It has nothing to do with cleanliness in most cases. DD had 8 before her first birthday despite daily abx and other preventative measures.

OP - I also wanted to add that an ultrasound can't rule out kidney reflux, only a VCUG can do that. An u/s will show most significant abnormalities, but dd has always had normal u/s and still has reflux, high grade as well as other renal abnormalities that did not show up on the u/s. Don't want to worry you, just thought I would mention it so that you know to watch for signs of recurring UTI. fwiw, our doctor says the cut-off age for ER and fever is 3 months, and then straight to the doctor until 6 months.

I'm glad your lo is feeling better. It's a really scary situation to have your babe that sick at such a young age.
post #17 of 31
Thread Starter 
Quote:
Originally Posted by workjw View Post
Often the only symptom is high fever, sometimes poor eating, lethargy (which is sometimes hard to detect in infants). Some children are just predisposed to UTI, but often in cases of infant UTI, the child has a condition called vesicoureteral reflux (kidney reflux) where the urine moves from the bladder into the kidneys where it can cause serious complications and permanent damage. As for how they get them, no one can really say. It has nothing to do with cleanliness in most cases. DD had 8 before her first birthday despite daily abx and other preventative measures.

OP - I also wanted to add that an ultrasound can't rule out kidney reflux, only a VCUG can do that. An u/s will show most significant abnormalities, but dd has always had normal u/s and still has reflux, high grade as well as other renal abnormalities that did not show up on the u/s. Don't want to worry you, just thought I would mention it so that you know to watch for signs of recurring UTI. fwiw, our doctor says the cut-off age for ER and fever is 3 months, and then straight to the doctor until 6 months.

I'm glad your lo is feeling better. It's a really scary situation to have your babe that sick at such a young age.
Can you tell me what VCUG stands for?

I see the ped on Saturday and I'll ask about this. I'm in France, so I need to find out what this procedure is called here.

ETA: N/m. Google is my friend.

TIA
post #18 of 31
Thread Starter 
Sorry to serial post.

workjw, thanks so much for the information. I'm bummed to know that there's a chance we'll be back in the hospital if DS has a reflux problem. I know that the u/s was to check for structural abnormalities and to see how far the infection had progressed. So they never told me they'd be able to totally rule out reflux.

The VCUG sounds pretty horrible, but hey, if we end up having to do it, we'll survive.

Does your daughter still struggle with this issue? Can it be outgrown? Ugh. What a horrible thing.
post #19 of 31
No signs....serious...requires medical attention...sounds like UTIs are the real thing to fear! (Sorry, not trying to debate, just a no vax mama).
post #20 of 31
Quote:
Originally Posted by claddaghmom View Post
No signs....serious...requires medical attention...sounds like UTIs are the real thing to fear! (Sorry, not trying to debate, just a no vax mama).
I'm not sure I understand what you mean? Are you saying UTI's are not something to fear? (also not trying to debate, just don't know what you mean) ftr, we are selectively, delayed vax, but still not sure what that has to do with UTIs
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